| NPI | 1548299316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 006850) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 006850-1) |
| 208800000X Urology (Licence: NY 006850) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2025-09-25 |